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Coronavirus disease 2019 and the placenta: A literature review

Samwel R Gesaka1, Moses M Obimbo2, Anthony Wanyoro3

  • 1Basic Clinical and Translational (BCT) Research Laboratory, University of Nairobi, Nairobi, Kenya.

Placenta
|July 25, 2022
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can infect the placenta, affecting pregnancy. Viral entry mediators and pathogenesis mechanisms in placental tissues require further investigation.

Area of Science:

  • Obstetrics and Gynecology
  • Virology
  • Pathology

Background:

  • Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, impacts multiple organs.
  • Understanding SARS-CoV-2's role in placental pathology is crucial due to the virus's novelty.
  • Existing literature on placental SARS-CoV-2 infection requires synthesis.

Purpose of the Study:

  • To review and evaluate the existing literature on SARS-CoV-2 in the placenta.
  • To examine viral mediators, entry mechanisms, pathogenesis, detection, and pathology.
  • To identify knowledge gaps regarding placental SARS-CoV-2 infection.

Main Methods:

  • Systematic literature search yielding 96 eligible studies.
  • Analysis of studies reporting on SARS-CoV-2 mediators, receptors, and factors in placental tissues.
  • Review of methods for viral detection (in situ hybridization, PCR, etc.) and reported placental pathologies.

Main Results:

  • Canonical mediators (ACE2, TMPRSS2) and other factors (SCARFs) are expressed in placental cells, influencing viral permissiveness.
  • Viral RNA, proteins, and particles were detected primarily in syncytiotrophoblasts (STBs).
  • Observed placental pathologies included maternal-fetal vascular malperfusion and inflammatory responses.

Conclusions:

  • The placenta is predisposed to SARS-CoV-2 infection due to the expression of viral receptors and pathogenesis-related genes.
  • SARS-CoV-2 infection can occur across all pregnancy trimesters, potentially exacerbated by pre-existing placental conditions.
  • Further research is needed to fully elucidate the mechanisms of SARS-CoV-2 entry and pathogenesis in the placenta.

Keywords:
ACE2Placental infectionPlacental pathologySARS-CoV-2Single-cell analysis

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